Can New Antivirals Against COVID-19 Solve Staff Shortages?
One answer to the healthcare staffing shortages could be a newly developed antiviral that works against SARS-CoV-2 much like influenza antivirals negate the symptoms of flu. Developed by Pfizer, Paxlovid is under an emergency use authorization by the FDA.
Jeanne Marrazzo, MD, MPH, infectious diseases director at the University of Alabama at Birmingham, said it is one of the most promising oral antiviral medications to come on the market.
“I think I’m most optimistic about the Paxlovid because it’s an oral drug that is [taken] for five days,” she said at briefing by the Infectious Diseases Society of America (IDSA).1 “I think of it as very similar to Tamiflu [for flu], and can really make a big difference if we start it early. If we could gear that up and get it to people, I think that would address so much of our staffing problems, because we could keep people out of the hospital, we could prevent severe illness, and it looks like a pretty safe drug.”
Paxlovid consists of two medicines, nirmatrelvir and ritonavir, which are taken together as tablets for five days.
“Right now, we have a really serious healthcare workforce issue,” Eric Topol, MD, a professor of molecular medicine and director and founder of the Scripps Research Translational Institute in La Jolla, CA, said in an interview.2 “One of the major features of this drug is you get more than a tenfold drop in the viral load very quickly. Whether it’s a nurse, physician, a clinician who gets COVID, you could basically stop the transmission very quickly with few pills.”
There are concerns the medication could select out for resistant virus if used on a wide scale, but these questions need to be answered so the drug can be brought to bear against spreading omicron and treat more healthcare workers and patients.
“If we had this in every medicine cabinet [when] you get a new diagnosis and starting to get some symptoms, you would essentially be able to abort the replication of the virus,” Topol said. “It’s not dependent on your immune response, which is really important.”
Moreover, the drug’s effectiveness should not waver by variant because it works against the SARS-CoV-2 main protease, which contains only one mutation after two years.
“It’s not a region of the virus that’s prone to mutations,” Topol said. “I’ve called it a just-in-time breakthrough. In fact, with omicron, it couldn’t have come at a better time — but the short supply is what really is distressing.”
- Infectious Diseases Society of America. IDSA media briefing: COVID-19 & omicron — practical advice. Jan. 11, 2022.
- UCSF Medicine. The omicron whirlwind: A conversation with Eric Topol — the current and future state of the pandemic. Jan. 13, 2022.
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